徒手膨肺联合胸廓振动挤压在机械通气患者开放式吸痰中的应用效果  

Application of Manual Hyperinflation Combined with Chest Vibration Extrusion in Patients with Mechanical Ventilation and Open Sputum Aspiration Bare-handed Bulking Combined with Thoracic Vibration Extrusion

作　　者：惠珂[1] 刘凌华[1] 霍树芬[1] 王君[1] 宋敏[1] 苏萍 HUI Ke;LIU Ling-hua;HUO Shu-fen(The Second Department of Respiratory and Critical,Shaanxi Provincial People's Hospital,Xi'an Shaanxi 710068)

机构地区：[1]陕西省人民医院呼吸与危重症二科,陕西西安710068 [2]延安市人民医院感控科,陕西延安716000

出　　处：《医学临床研究》2022年第7期1051-1053,1057,共4页Journal of Clinical Research

摘　　要：【目的】探讨徒手膨肺联合胸廓振动挤压在机械通气患者开放式吸痰中的应用效果。【方法】选取2019年6月至2020年6月在陕西省人民医院诊治的128例机械通气患者开放式吸痰患者,按照患者入院先后分为常规组(采用常规排痰护理)和联合组(采用徒手膨肺联合胸廓振动挤压排痰),比较两组患者气道阻力、肺顺应性、氧合指数、拔管时间、周排痰量、肺部感染评分(Clinical pulmonary infection score,CPIS)及肺不张、感染相关脱机失败的发生率。【结果】两组患者操作前后气道阻力、肺顺应性、氧合指数比较,差异均有统计学意义(P<0.05);操作后,联合组气道阻力、拔管时间、CPIS评分均显著低于常规组(P<0.05);肺顺应性、氧合指数、周排痰量均显著高于常规组(P<0.05)。联合组肺不张、感染相关脱机失败的发生率均显著低于常规组(P<0.05)。【结论】徒手膨肺结合胸廓振动挤压应用于机械通气患者的开放式吸痰中,可改善患者呼吸功能,缩短拔管时间,促进痰液有效排除,降低肺不张及继发感染风险。【Objective】To observe the effect of manual hyperinflation combined with chest vibration extrusion in patients of mechanical ventilation with open sputum aspiration.【Methods】A total of 128 patients undergoing open sputum aspiration when mechanically ventilated in Shaanxi Provincial People's Hospital from June 2019 to June 2020 were selected,According to the admission of the patients,the patients were divided into the conventional group(with routine sputum discharge)and the joint group,the routine group used the routine sputum discharge care,the combined group used manual hyperinflation combined with the chest vibration extrusion method for sputum discharge,The airway resistance,lung compliance,oxygenation index changes,time to extubation,peripheral sputum discharge,pulmonary infection score(clinical pulmonary infection score,CPIS),atelectasis,and infection-related weaning failure rates were compared between the two groups.【Results】The airway resistance,lung compliance and oxygenation index of the two groups were statistically significant before and after the operation(P<0.05).After operation,the airway resistance,extubation time and CPIS score in the combined group were significantly lower than those in the conventional group(P<0.05);lung compliance,oxygenation index,and weekly sputum volume were significantly higher than those in the conventional group(P<0.05).The incidence of atelectasis and infection related weaning failure in the combined group were significantly lower than those in the conventional group(P<0.05).【Conclusion】Manual hyperinflation combined with thoracic vibration extrusion is suitable for nursing patients with process of open sputum suction and mechanical ventilation.During operation,it can improve respiratory function,shorten extubation time,promote effective elimination of sputum,and reduce the risk of atelectasis and secondary infection.

关 键 词：呼吸 人工/方法 痰 抽吸 

分 类 号：R332.3[医药卫生—人体生理学]